GRACE CATHERINE MICKLE (NPI# 1750932414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750932414 |
| Entity Type | Individual |
| Full Name | GRACE CATHERINE MICKLE |
| Practice Address |
1260 Morena Blvd Ste 100 San Diego CA 92110-3850 |
| Practice Telephone | 6193980355 |
| Mailing Telephone | 6193980355 |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2020-10-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
CA | Behavioral Health & Social Service Providers | |
| N | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
1260 MORENA BLVD STE 100 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92110-3850 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699857813 | Luckvin Ponsingh Manuel | Psychiatry & Neurology | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2006-10-19 |
| 1700483476 | Lucinne Kafka | Counselor | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-10-06 |
| 1003422080 | Michelle Renee Zittlau-johnson | Registered Nurse | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-09-16 |
| 1780202994 | Robert Ivar Lindbloom | Peer Specialist | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-07-14 |
| 1720605538 | Dylan Clements Landon | Counselor | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-06-26 |
| 1134742463 | Vivienne M Hickey | Student in an Organized Health Care Education/Training Program | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-05-20 |
| 1124653480 | Marina Spacek | Counselor | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-03-06 |
| 1871126466 | John P Gallagher Jr. | Counselor | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2020-02-21 |
| 1861031452 | Laila Wahib | Counselor | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2019-12-30 |
| 1508419391 | Mara Mcbride | Registered Nurse | 1260 Morena Blvd Ste 100, San Diego, CA 92110-3850 | 2019-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669021713 | Ruben Daniel Gutierrez | Marriage & Family Therapist | 4141 Pacific Coast Hwy, San Diego, CA 92110 | 2019-09-10 |
| 1548724081 | Denise Ellen Thompson | Counselor | 3255 Wings Street, San Diego, CA 92110 | 2019-01-29 |
| 1801378716 | Michelle Lisa Jean Crawford | Student in an Organized Health Care Education/Training Program | 3767 Central Avenue, San Diego, CA 92110 | 2018-09-06 |
| 1427539048 | Allison Turrell | Case Manager/Care Coordinator | 4930 Naples Street, San Diego, CA 92110 | 2018-08-22 |
| 1750872768 | Matthew Langworthy | Physical Therapist | 3405 Kenyon St Ste 212, San Diego, CA 92110 | 2018-05-24 |
| 1245748342 | The One Health Boutique, LLC | Chiropractor | 5350 Riley St, San Diego, CA 92110 | 2018-01-11 |
| 1437670155 | Monique A Fernandez | Counselor | 3132 Jefferson Street, San Diego, CA 92110 | 2017-07-03 |
| 1538510391 | Mayu Winters | Registered Nurse | 853 Rosecrans St, San Diego, CA 92110 | 2016-06-23 |
| 1376998864 | Briniti Ichull | Specialist | 3941 Kurtz St, San Diego, CA 92110 | 2016-05-03 |
| 1912352576 | Healthcare Services, Inc. | Substance Abuse Rehabilitation Facility | 3880 Rosecrans Street, San Diego, CA 92110 | 2016-05-02 |
| Find all providers in zip 92110 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346359 | Christina L Thomas | Counselor | 4611 Alamo Dr, San Diego, CA 92115-5907 | 2020-11-05 |
| 1639779101 | Paula Perez | Counselor | 5882 Adobe Falls Rd, San Diego, CA 92120-4600 | 2020-10-26 |
| 1558974378 | Monica Dixon | Counselor | 4930 Naples St Fl 1, San Diego, CA 92110-3820 | 2020-08-31 |
| 1952911612 | Shannon Kathleen Nolte | Counselor | 13111 Kellam Ct Apt 9, San Diego, CA 92130-1251 | 2020-08-06 |
| 1033728498 | Hala Kadhem | Counselor | 1664 Broadway, El Cajon, San Diego, CA 92021 | 2020-07-30 |
| 1487279493 | Christi Susan Leyva | Counselor | 10417 Crosscreek Ter, San Diego, CA 92131-1344 | 2020-06-15 |
| 1285256099 | Jehna Barnes | Counselor | 3636 Camino Del Rio N, San Diego, CA 92108-1703 | 2020-05-14 |
| 1457973455 | Cassandra Detgen | Counselor | 5252 Orange Ave Unit 125, San Diego, CA 92115-6029 | 2020-05-12 |
| 1972131589 | Douglas Baker Marriage and Family Therapy, Inc. | Counselor | 2911 Adams Ave # 5, San Diego, CA 92116-1509 | 2020-03-30 |
| 1255966859 | Job Brunat | Counselor | 4169 38th St Apt 10, San Diego, CA 92105-1367 | 2020-03-04 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.